Adverse condition detection, assessment, and response systems, methods and devices

ABSTRACT

A method comprises receiving an input indicative of at least one factor that contributes to the development of pressure ulcers; determining a risk score as a function of the input; comparing the risk score to a previous risk score; and at least one of activating a therapy configured to reduce the magnitude of the factor and notifying a caregiver if the risk score is greater than the previous risk score.

This disclosure claims priority to U.S. Provisional Application Ser. No.61/650,436, filed on May 22, 2012 and titled ADVERSE CONDITIONDETECTION, ASSESSMENT, AND RESPONSE SYSTEMS, METHODS AND DEVICES, thecontents of which are incorporated herein by reference.

BACKGROUND OF THE DISCLOSURE

This disclosure relates generally to adverse condition detection,assessment, and response systems, devices and methods. Moreparticularly, but not exclusively, one contemplated embodiment relatesto a system configured to monitor for physiological factors thatcontribute to skin breakdown, assess the likelihood of skin breakdown,and take appropriate action to prevent skin breakdown. While varioussystems have been developed, there is still room for improvement. Thus,a need persists for further contributions in this area of technology.

SUMMARY OF THE DISCLOSURE

In contemplated embodiment, a method comprises receiving an inputindicative of a factor that contribute to the development of pressureulcers; comparing the input to a predetermined threshold; and if theinput exceeds the threshold, notifying a caregiver that a pressure ulcermay develop.

In another contemplated embodiment, a method comprises receiving aninput indicative of a factor that contribute to the development ofpressure ulcers; comparing the input to a predetermined threshold; andif the input exceeds the threshold, activating a therapy configured toreduce the magnitude of the input.

In another contemplated embodiment, a method comprises receiving aninput indicative of a factor that contribute to the development ofpressure ulcers; determining a Braden score of a person as a function ofthe input; comparing the Braden score to a predetermined threshold; andif the input exceeds the threshold, activating a therapy configured toreduce the magnitude of the input.

In another contemplated embodiment, a method comprises receiving a firstinput indicative of a factor that contribute to the development ofpressure ulcers; receiving a second input indicative of a factor thatcontribute to the development of pressure ulcers a predetermined timeafter receiving the first input; determining the difference between thefirst input and the second input; if the difference indicates anincrease in the factor that contributes to the development of pressureulcers, activating a therapy configured to reduce the magnitude of thefactor.

In another contemplated embodiment, a method comprises receiving a firstinput indicative of a factor that contribute to the development ofpressure ulcers; receiving a second input indicative of a factor thatcontribute to the development of pressure ulcers a predetermined timeafter receiving the first input; determining a first Braden score as afunction of the first input; determining a second Braden score as afunction of the second input; comparing the first Braden score to thesecond Braden score; and if the first Braden score is less than thesecond Braden score, activating a therapy configured to reduce themagnitude of the factor.

In another contemplated embodiment, a method comprises receiving a firstinput indicative of a factor that contribute to the development ofpressure ulcers; receiving a second input indicative of a factor thatcontribute to the development of pressure ulcers a predetermined timeafter receiving the first input; determining a first Braden score as afunction of the first input; determining a second Braden score as afunction of the second input; comparing the first Braden score to thesecond Braden score; and if the first Braden score is less than thesecond Braden score, notify a caregiver.

In another contemplated embodiment, a method comprises receiving anfirst input indicative of a characteristic of a patient; receiving asecond input indicative of at least one factor that contributes to thedevelopment of pressure ulcers, wherein at least one of the at least onefactor is ignored as a function of the first input; comparing the secondinput to a predetermined threshold; if the difference indicates anincrease in the factor that contributes to the development of pressureulcers, at least one of activating a therapy configured to reduce themagnitude of the factor and notifying a caregiver.

Additional features alone or in combination with any other feature(s),including those listed above and those listed in the claims and thosedescribed in detail below, can comprise patentable subject matter.Others will become apparent to those skilled in the art uponconsideration of the following detailed description of illustrativeembodiments exemplifying the best mode of carrying out the invention aspresently perceived.

BRIEF DESCRIPTION OF THE DRAWINGS

Referring now to the illustrative examples in the drawings, wherein likenumerals represent the same or similar elements throughout:

FIG. 1 is a diagrammatic view of adverse condition detection,assessment, and response system including a person support apparatus, aperson support surface, and a control system according to onecontemplated embodiment of the disclosure;

FIG. 2 is a side perspective view of the person support apparatus ofFIG. 1 showing the various components of the upper and lower frame;

FIG. 3 is a side cross-sectional view of the person support surface ofFIG. 1 showing the various sections of the mattress and how theycorrespond to the sections of the upper frame that support the mattress;

FIG. 4 is a diagrammatic view of the person support surface of FIG. 1showing the mattress, topper, and fluid supply;

FIG. 5 is a perspective side view of the person support surface showingthe sensors in coupled to the topper;

FIG. 6 is a diagrammatic side view of a low air loss topper on amattress;

FIG. 7 is a flow chart showing a table of information that is received,a decision support table derived from the information, and a reactiontable listing possible interventions;

FIG. 8 is a flow chart showing a table of information that is received,a decision support table derived from the information, and a reactiontable listing possible interventions according to another contemplatedembodiment; and

FIG. 9 is a flow chart of a procedure for monitor for physiologicalfactors that contribute to skin breakdown, assess the likelihood of skinbreakdown, and take appropriate action to prevent skin breakdown.

DETAILED DESCRIPTION OF THE DRAWINGS

While the present disclosure can take many different forms, for thepurpose of promoting an understanding of the principles of thedisclosure, reference will now be made to the embodiments illustrated inthe drawings, and specific language will be used to describe the same.No limitation of the scope of the disclosure is thereby intended.Various alterations, further modifications of the described embodiments,and any further applications of the principles of the disclosure, asdescribed herein, are contemplated.

FIG. 1 shows adverse condition detection, assessment, and responsesystem 10 according to one contemplated embodiment. The system 10 isconfigured to monitor physiological factors that can contribute to skinbreakdown and the development of pressure ulcers, provide decisionsupport that evaluates what response, if any, is appropriate upondetecting or predicting the occurrence of such a condition, andimplement an intervention to address those factors and protect theperson's skin from damage. The factors the system 10 measures include,but are not limited to, interface pressure, skin temperature, skinmoisture, incontinence, degree and presence of tissue damage or pressureulcers, lack of motion (i.e., not adjusting their position), lack ofactivity (i.e., not leaving the person support structure), amount ofshear, amount of friction, and the type of person support surface beingused. The system can detect both a location and duration of the factor(i.e., what body part experienced excessive pressure and for how long).The system 10 could periodically or continuously monitor the factors.Sensors used to measure the factors may be coupled to a person supportapparatus, included in a person support surface, integrated into linensor garments or underpads, or worn by the patient, and can connectwirelessly to the system 10.

The system 10 may be in communication with the emergency medical record(EMR) or other care facility record or database system and receiveinformation necessary to determine the person's risk for skin breakdownor other factors that would influence the caregiver's treatmentdecision. In one example, the system 10 receives information from theEMR including, but not limited to, the person's medical history, medicaldiagnosis, medications, Braden score, and risk analyses. In anotherexample, the system 10 receives information from the institutional careprotocol, which defines the care that should be given to a patient inorder to help prevent skin breakdown. The care protocol can includeinformation, such as, when a specialty person support surface needs tobe used, when a therapy should be used, when a catheter should be used,the frequency at which the patient should be turned, and other careprocedures.

The system 10 can respond to the detected factors that exceed apredetermined threshold by activating a therapy, such as, targetedcooling, heat and moisture regulation, patient turning, and othertherapies, or notifying a caregiver and requesting that a caregiverperform some actions, such as, reposition at least a portion of thepatient, apply a salve or pH neutralizing solution, or other careprotocol procedures. The system 10 can also provide information to theEMR or other care facility database or record system for compliancereporting and charting.

The system 10 includes a person support apparatus 12, a person supportsurface 14, a fluid supply FS1, and a control system 16. In somecontemplated embodiments, the person support apparatus 12 is a hospitalbed frame and the person support surface 14 is supported thereon. Inother contemplated embodiments, the person support apparatus 12 can be astretcher, an operating room table, or other person supportingstructure. The person support apparatus 12 includes a lower frame 17,supports 18 or lift mechanisms 18 coupled to the lower frame 17, and anupper frame 20 movably supported above the lower frame 17 by thesupports 18. The lift mechanisms 18 are configured to raise and lowerthe upper frame 20 with respect to the lower frame 17 and move the upperframe 20 between various orientations, such as, Trendellenburg andreverse Trendellenburg.

The upper frame 20 includes an upper frame base 24 and a deck 26 coupledto the upper frame base 24. The deck 26 includes a calf section 28, athigh section 30, a seat section 32, and a head and torso section 34 asshown in FIG. 3. The calf section 28 and the thigh section 30 define alower limb support section LL1. The head and torso section 34 define anupper body support section U1. The seat section 32 defines the seatsection S1. The calf section 28, the thigh section 30, and the seatsection 32 define a lower body support section LB1. At least the calfsection 28, the thigh section 30, and the head and torso section 34 aremovable with respect to one another and/or the upper frame base 24. Insome contemplated embodiments, the calf section 28, the thigh section30, the seat section 32, and the head and torso section 34 cooperate tomove the person support apparatus 12 between an substantially planar orlying down configuration and a chair configuration. In some contemplatedembodiments, the calf section 28, the thigh section 30, the seat section32, and the head and torso section 34 cooperate to move the personsupport apparatus 12 between a substantially planar or lying downconfiguration and an angled or reclined configuration. In somecontemplated embodiments, the head and torso section 34 is moved suchthat it is at an angle of at least about 30° with respect to a referenceplane RP1 passing through the upper frame 20.

The person support surface 14 is configured to support a person thereonand move with the deck 20 between the various configurations. The personsupport surface 14 includes a calf portion 36, a thigh portion 38, aseat portion 40, and a head and torso portion 42 as shown in FIG. 3,which is supported on corresponding sections of the deck 26. In onecontemplated embodiment, the deck sections help move and/or maintain thevarious portions of the mattress MT1 at angles α, β and γ with respectto the reference plane RP1.

The person support surface 14 includes a mattress MT1 and a heat andmoisture regulating topper TP1. In some contemplated embodiments, apressure mapping mat (not shown) is positioned on the mattress MT1 ortopper TP1 or incorporated therein. In some contemplated embodiments,the mattress MT1 is a non-powered (static) mattress. In somecontemplated embodiments, the mattress MT1 is a powered (dynamic)mattress configured to receive fluid from a fluid supply FS1 as shown inFIG. 5. In some contemplated embodiments, the mattress MT1 is a consumermattress.

The mattress MT1 includes a mattress cover 44 and a mattress core 46enclosed by the mattress cover 44. The mattress core 46 can be composedof a single type of material or a combination of materials and/ordevices. In the case of a powered surface, the mattress core 46 includesat least one fluid bladder 54 therein that receives fluid from a fluidsupply FS1 to maintain the fluid pressure within the fluid bladder 54 ata predetermined level. In some contemplated embodiments, the poweredsurface can include non-powered components, such as, a foam frame thatat least one fluid bladder 54 is positioned between. In somecontemplated embodiments, wedge shaped bladders are mirrored laterallyabout the centerline of the mattress MT1 and are configured to beinflated consecutively to laterally tilt the occupant, thereby relievingpressure on various portions of the occupant's body to help reduce theoccurrences of pressure ulcers.

In the case of a non-powered mattress, the mattress core 46 is composedof a cellular engineered material, such as, single density foam. In somecontemplated embodiments, the mattress core 46 includes at least onebladder 54, such as, a static air bladder or a static air bladder withfoam contained there within, a metal spring and/or other non-poweredsupport elements or combinations thereof. In some contemplatedembodiments, the mattress core 46 and includes multiple zones withdifferent support characteristics configured to enhance pressureredistribution as a function of the proportional differences of aperson's body. Also, in some embodiments, the mattress core 46 includesvarious layers and/or sections of foam having different impression loaddeflection (ILD) characteristics, such as, in the NP100 PreventionSurface, AccuMax Quantum™ VPC Therapy Surface, and NP200 Wound Surfacessold by Hill-Rom®.

The topper TP1 is positioned on the mattress and is used to regulate theamount heat and moisture produced by a person supported on the topperTP1. In some contemplated embodiments, the topper TP1 can be integratedinto the mattress MT1. In some contemplated embodiments, the topper TP1can be used to regulate the amount of heat and moisture present at ornear the interface between the occupant supported on the topper TP1 andthe topper TP1. In some contemplated embodiments, the topper TP1 is alow-air loss topper.

Low air-loss broadly refers to a feature of a support surface thatprovides a flow of air to assist in managing the heat and humidity ofthe skin. Two types of mechanisms that low air-loss support devicestypically use to remove accumulated moisture and heat: convectiveevaporation and diffusive evaporation. Convective evaporation evaporatesaccumulated moisture by blowing air on the skin or drawing air away fromthe skin. In some contemplated embodiments, air can be blown on the skinthrough the upper surface of the topper TP1 that interfaces with thepatient. In some contemplated embodiments, air can be drawn through theupper surface of the topper TP1 that interfaces with the patient andthrough the topper toward an exit by the fluid supply FS1. Diffusiveevaporation evaporates accumulated moisture through and under thesurface of the support device to cool the skin without blowing airdirectly thereon. One example of a diffusive device can be seen in FIG.5 where the patient is lying on the topper in the supine position withfluid F1 flowing through the topper to remove heat H1 and moisture M1radiated by the patient. In some contemplated embodiments, the lowair-loss devices include a combination of diffusive and convectiveevaporation.

The topper TP1 includes a ticking TK1, an inlet IL1, athree-dimensionally engineered spacer SP1, and an outlet OL1. Theticking TK1 defines a chamber TC1 that the three-dimensionallyengineered spacer SP1 is positioned within and is moisture permeable andair impermeable. In some contemplated embodiment, the ticking TK1 can beboth moisture permeable and air permeable. In some contemplatedembodiment, the mattress cover 44 and the ticking TK1 can be composed ofthe same material and have the same physical characteristics. The inletIL1 is positioned along a side of the topper TP1 and allows for fluid tobe communicated from the fluid supply FS1 into the chamber TC1.

The outlet OL1 is positioned along a side of the topper TP1 opposite theinlet IL1 and allows fluid entering the chamber TC1 through the inletIL1 to pass through the chamber TC1 and exit the topper. In somecontemplated embodiments, no vent is provided where air is able to becommunicated through the upper surface of the topper TP1 that interfaceswith the patient.

The spacer SP1 positioned within the chamber TC1 and helps maintain apath for the fluid from the fluid supply FS1 to flow through the chamberTC1 while a person is positioned thereon. In some contemplatedembodiments, the three-dimensionally engineered spacer SP1 is composedof SpaceNet®, which is a product of Freudenberg. In other contemplatedembodiments, the three-dimensionally engineered spacer 48 can becomposed of other materials having a high fluid porosity and having someresistance against flattening. In some contemplated embodiments, thethree-dimensionally engineered spacer SP1 includes at least one chamberand/or bladder (not shown) there within.

The fluid supply FS1 can be an air blower that can supply air to themattress MT1 and topper TP1. The fluid supply FS1 can removably couplewith the mattress MT1 and topper TP1 via a hose FH1. In somecontemplated embodiments, fluid supply FS1 can also include a heatingelement (not shown) and/or a cooling element (not shown) that can heatand/or cool the fluid being supplied, and/or a filter (not shown)configured to filter the fluid being supplied.

The control system 16 is configured to assess and respond to adverseconditions that are detected. The control system 16 includes a processor100, an input 102, and memory 104. In some contemplated embodiments, theinput 102 is a sensor 106, such as, an image capture device or videocamera, a 3D image sensor, a pressure sensor, a temperature sensor, anacoustic sensor, a force sensor, a moisture sensor, an accelerometer, apiezoelectric sensor, an ultrasonic sensor or other sensor configured toprovide patient and environmental information to the processor 100 thatis indicative of the status of a therapy, an identity of the personsupport surface being used, or a characteristic of the person, such as,the person's heart rate, respiration rate, respiration amplitude, skintemperature, weight, sleep state, body orientation, position, and/orother physiological characteristics or information about the person'scondition. In some contemplated embodiments, the temperature, force,pressure, moisture, and ultrasonic sensors are incorporated into themattress MT1 and/or topper TP1. In some contemplated embodiments, theaccelerometer and piezoelectric sensors are coupled to garments, linens,or the person's skin. In some contemplated embodiments, the force, 3Dimage, and video sensors are coupled to the person support apparatus 12.In some contemplated embodiments, the 3D image, video and ultrasonicsensors are positioned in the room proximate to the person. In somecontemplated embodiments, the sensors 106 are incorporated into theperson support surface 14 or in a topper positioned on the personsupport surface 14, for example, as disclosed in U.S. Pat. No. 7,515,059to Price et al., U.S. Patent Publication No. 2011/0068928 to Riley etal., and U.S. Patent Publication No. 2011/0024076 to Lachenbruch, et al.In some contemplated embodiments, the sensors 106 are positioned on thepatient contacting surface of the topper TP1 or mattress MT1, in thechamber TC1, or in the ticking TK1. In some contemplated embodiments,the sensors 106 are load cells coupled to the upper frame 20. In somecontemplated embodiments, the input 102 is a user interface 108configured to receive information from a caregiver or other user. Insome contemplated embodiments, the input 102 is a pressure mapping matpositioned on the person support surface 14. In some contemplatedembodiments, the sensors 106 communicate wirelessly with the controlsystem 16.

In some contemplated embodiments, friction and shear can be determinedusing a combination of the ultrasonic sensor, 3D image sensor, and/orimage capture device and the pressure sensor and/or force sensor sensingthe amount of pressure and force on the topper TP1 and the vertical andhorizontal components of the movement of a person's body with respect tothe surface. In one contemplated embodiment, if the coefficient offriction for the surface is known, the amount of friction the personexperiences as a result of their weight can be calculated. In onecontemplated embodiment, if the amount of the person has a smallvertical component to their movement and their horizontal movementcomponent is larger, the person may be experiencing a shear force. Insome contemplated embodiments, the Doppler method can be used to measurethe movement of the person, for example, their heart, with respect tothe surface. In some contemplated embodiments, the stress on a person'sskin can be calculated using the shear forces, the friction, the skintemperature, and the skin moisture level.

In some contemplated embodiments, the input 102 receives informationfrom a remote database or system, such as, an Electronic Medical Record(EMR) system 110 or care facility record or information databases, incommunication with the processor 100 via a care facility network 112. Insome contemplated embodiments, the information includes, but is notlimited to, risk assessments for the person, medical history,medications, Braden scores, health conditions, nutritional informationfor the person, assessed sensory perception information, staffing levelsfor the facility, care facility standard protocols, caregiver alarmpreferences, agitation level of the person, and other informationrelated to the person, caregiver, and care facility. In somecontemplated embodiments, the processor 100 can output information,automatically or manually upon caregiver input, to the EMR for charting,which can include therapy initiation and termination, adverse eventoccurrence information, therapy protocol used, caregiver ID, and anyother information associated with the occupant, caregiver, personsupport apparatus 12, person support surface 14, and adverse event.

The inputs 102 provide patient and environmental information that mayinclude both spatial and temporal components and may relate to a varietyof things, including, but not limited to, the person's currentdiagnosis, medications the person is taking, the person's physiologicalcharacteristics, the person's medical history, risk assessmentsperformed by a caregiver, medical procedures the person has undergone,the status of medical equipment in the vicinity of the person or that isassociated with the person (i.e., the person support apparatus 12 andthe person support surface 14), care facility protocols and procedures,care facility logistics, caregiver or patient inputs, and otherinformation about the person, medical devices, caregivers, and carefacility that can be provided by an EMR or a patient activity log,gathered by and from the person support apparatus 12 and mattress MT1and other medical devices assigned to the person, or through the carefacility network.

The memory 104 stores one or more instruction sets configured to beexecuted by the processor 100 when the occupant egress prediction system10 is armed. In some contemplated embodiments, the system 10 is armedmanually by the caregiver or automatically based on information from thepatient's EMR, the caregiver, and/or a protocol triggered by the riskprofile of the patient. The instruction sets define procedures 114 thatcause the processor 100 to implement one or more protocols that alert acaregiver via a communication system (not shown) when the system 10detects or determines that a pressure ulcer has formed or may form overtime if no intervention is implemented.

The communication system can be used to alert a caregiver proximate tothe person support apparatus 14 (i.e., in the same room or in the hallway connected to the room) and a caregiver remote from the personsupport apparatus 14. In some contemplated embodiments, thecommunication system is a patient/nurse call system that can includepatient stations capable of generating hospital calls and a remotemaster station which can prioritize and store the calls. One example ofsuch a system is disclosed in U.S. Pat. No. 5,561,412 issued on Oct. 1,1996 to Novak et al., which is incorporated by reference herein in itsentirety. Another example of such a system is disclosed in U.S. Pat. No.4,967,195 issued on May 8, 2006 to Shipley, which is incorporated byreference herein in its entirety. In another illustrative embodiment,the communication system can include a status board that displays thealert. The communication system can alert the caregiver by posting thealert to a status board, using a nurse call system, directly contactingthe caregiver on their phone or pager, providing a local alert over thefacility PA system, and opening a connection that allows the caregiverto speak directly to the patient. The communication can also escalatethe vigilance monitoring of the patient.

In another contemplated embodiment, the communication system is a systemfor transmitting voice and data in packets over a network with anysuitable number of intra-room networks that can couple a number of datadevices to an audio station, where the audio station couples therespective intra-room network to a packet based network. One example ofsuch a system is disclosed in U.S. Pat. No. 7,315,535 issued on Jan. 1,2008 to Schuman, which is incorporated by reference herein in itsentirety. Another example of such a system is disclosed in U.S. PatentPublication No. 2008/0095156 issued on Apr. 24, 2008 to Schuman, whichis incorporated by reference herein in its entirety.

In yet another contemplated embodiment, the communication system isincluded a patient/nurse call system, a nurse call/locating badge, anelectronic medical record (EMR) database, and one or more computersprogrammed with work-flow process software. One example of such a systemis disclosed in U.S. Patent Publication No. 2008/0094207 published onApr. 24, 2008 to Collins, J R. et al., which is incorporated byreference herein in its entirety. Another example of such a system isdisclosed in U.S. Patent Publication No. 2007/0210917 published on Sep.13, 2007 to Collins, J R. et al., which is incorporated by referenceherein in its entirety. Yet another example of such a system isdisclosed in U.S. Pat. No. 7,319,386 published on Jan. 15, 2008 toCollins, J R. et al., which is incorporated by reference herein in itsentirety. It should be appreciated that the work-flow process softwarecan be the NaviCare® software available from Hill-Rom Company, Inc. Itshould also be appreciated that the work-flow process software can bethe system disclosed in U.S. Pat. No. 7,443,303 issued on Oct. 28, 2008to Spear et al., which is incorporated by reference herein in itsentirety. It should further be appreciated that the badge can be of thetype available as part of the ComLinx™ system from Hill-Rom Company,Inc. It should also be appreciated that the badge can also be of thetype available from Vocera Communications, Inc.

In still another contemplated embodiment, the communication system isconfigured to organize, store, maintain and facilitate retrieval of bedstatus information, along with the various non-bed calls placed in ahospital wing or ward, and remotely identify and monitor the status andlocation of the person support apparatus, patients, and caregivers. Oneexample of such a system is disclosed in U.S. Pat. No. 7,242,308 issuedon Jul. 10, 2007 to Ulrich et al., which is incorporated by referenceherein in its entirety. It should be appreciated that the remote statusand location monitoring can be the system disclosed in U.S. Pat. No.7,242,306 issued on Jul. 10, 2007 to Wildman et al., which isincorporated by reference herein in its entirety. It should also beappreciated that the remote status and location monitoring can be thesystem disclosed in U.S. Patent Publication No. 2007/0247316 publishedon Oct. 25, 2007 to Wildman et al., which is incorporated by referenceherein in its entirety.

In one contemplated embodiment, the instruction set defines a procedure114 that causes the processor 100 to send the caregiver an alert via acommunication system (not shown) and/or activate a therapy upondetermining that skin breakdown has occurred or is predicted to occurbased on the information from the inputs 102. Procedure 114 begins withstep 116 in which the processor 100 receives patient and environmentalinformation from the input 102. In one example, the information from theinput 102 includes information used to populate a Braden score table. Inother examples, the information includes indicated in the table below:

Sensory Perception (ability to respond Moisture meaningfully to (degreeto which Activity Mobility pressure-related skin is exposed (degree ofphysical (ability to change and Nutrition discomfort) to moisture)activity) control body position) (usual food intake pattern) Friction &Shear 1. Completely 1. Constantly 1. Confined to 1. Completely 1. VeryPoor 1. Problem Limited Moist bed. Immobile (never eats a (requiresmoderate to (unresponsive to painful (skin is kept (does not make evencomplete meal. Rarely maximum assistance in stimuli, due to moist almostslight changes in body eats more than a of any moving. Completediminished level of constantly by or extremity position food offered.Eats 2 lifting without sliding consciousness or perspiration, withoutassistance) servings or less of protein against sheets is sedation, orlimited urine, etc. (meat or dairy products) per impossible. Frequentlyability to feel pain over Dampness is day. Takes fluids poorly. slidesdown in bed or most of the body) detected every Does not take a liquidchair, requiring frequent time patient is dietary supplement, or isrepositioning with moved or NPO and/or maintained maximum assistance.turned) on clear liquids or IV = s Spasticity, contractures for morethan 5 days) or agitation leads to almost constant friction) 2. VeryLimited 2. Very 2. Chairfast 2. Very Limited 2. Probably Inadequate 2.Potential (responds only to painful Moist (ability to walk (makesoccasional (rarely eats a complete meal Problem stimuli. Cannot (skin isoften, severely limited or slight changes in body and generally eatsonly about (moves feebly or communicate discomfort but not alwaysnon-existent. or extremity position 2 of any food offered. requiresminimum except by moaning or moist. Linen Cannot bear own but unable tomake Protein intake includes only assistance. During a restlessness, orhas a must be changed weight and/or must frequent or significant 3servings of meat or move skin probably sensory impairment at least oncea be assisted into changes dairy products per day. slides to some extentwhich limits the ability shift) chair or wheelchair) independently)Occasionally will take a against sheets, chair, to feel pain or dietarySupplement, or restraints or other discomfort over ½ of the receivesless than devices. Maintains body) optimum amount of relatively goodposition liquid diet or tube feeding) in chair or bed most of the timebut occasionally slides down) 3. Slightly Limited 3. Occasionally 3.Walks 3. Slightly 3. Adequate 3. No Apparent (responds to verbal Moist:Occasionally Limited (eats over half of most meals. Problem commands,but cannot (skin is (walks occasionally (makes frequent Eats a total of4 servings (moves in bed and in always communicate occasionally duringday, but for though slight changes of protein (meat, dairy chairindependently and discomfort or the need to moist, requiring very shortdistances, in body or extremity products per day. has sufficient musclebe turned, or has some an extra linen with or without positionOccasionally will refuse a strength to lift up sensory impairment changeassistance. Spends independently) meal, but will usually completelyduring move. which limits ability to approximately majority of each takea supplement when Maintains good position feel pain or discomfort once aday) shift in bed or chair) offered, or is on a tube in bed or chair) in1 or 2 extremities) feeding or TPN regimen which probably meets most ofnutritional needs) 4. No Impairment 4. Rarely 4. Walks 4. No Limitation4. Excellent (responds to verbal Moist Frequently (makes major and (eatsmost of every meal. commands. Has no (skin is usually (walks outsideroom frequent changes in Never refuses a meal. sensory deficit whichdry, linen only at least twice a day position without Usually eats atotal would limit ability to requires and inside room at assistance) of4 or more servings feel or voice pain or changing at least once everytwo of meat and dairy discomfort) routine intervals) hours duringproducts. Occasionally waking hours) eats between meals. Does notrequire supplementation) Scores             Total Score

In other examples, the information includes the status of a therapy, anidentity of the person support surface being used, or a characteristicof the person, such as, the person's heart rate, respiration rate,respiration amplitude, skin temperature, weight, sleep state, bodyorientation, position, and/or other physiological characteristics orinformation about the person's condition, the person's currentdiagnosis, medications the person is taking, the person's physiologicalcharacteristics, the person's medical history, risk assessmentsperformed by a caregiver, medical procedures the person has undergone,the status of medical equipment in the vicinity of the person or that isassociated with the person (i.e., the person support apparatus 12 andthe person support surface 14), care facility protocols and procedures,care facility logistics, caregiver or patient inputs and otherinformation about the person, medical devices, caregivers, and carefacility that can be provided by an EMR or a patient activity log,gathered by and from the person support apparatus 12 and mattress MT1and other medical devices assigned to the person, or through the carefacility network.

In step 118, the processor 100 inputs the information into a table, suchas, a Braden score table. It should be appreciated that this step is notnecessary for instances where a score table is not desired or needed.

In step 120, the processor 100 determines what the level of risk of skinbreakdown as a function of the inputs. In one contemplated embodiment,the processor calculates a risk score based on the Braden score table.In one example, if the amount of moisture sensed is high (2), theperson's level of activity is medium (3), they don't eat often (2), andthe person is able to reposition themselves easily (3,3), the person mayhave a moderate risk of developing a pressure ulcer based on the Bradenscore table. In another contemplated embodiment, the processor 100compares the inputs to predetermined thresholds. In some contemplatedembodiments, the thresholds are set by the facility care protocol. Inanother contemplated embodiment, the thresholds are set based on acaregiver assessment, a data set, which can specify thresholds based onthe person's age, sex, weight, height and other information, or based onthe person's history, which can take into account whether the person isa diabetic or is on medication that may affect the skin temperature andmoisture levels. In another contemplated embodiment the threshold can bethe last set of inputs received or the last caregiver assessment. Insome contemplated embodiments, certain information may not be consideredor given less weight based on information about the patient. Forexample, pressure readings may not be considered for children, butincontinence is given more weight.

Once the level of risk is determined, the processor 100 determineswhether an intervention is required. In one contemplated embodiment, theprocessor examines the hospital protocol in step 122 and determines whatprocedures are prescribed by the protocol. One example may be toactivate a low air loss therapy by activating the fluid supply FS1 andcommunicating air through the topper TP1 to remove excess moisture andheat from the skin. Another example may be to activate a lateralrotation therapy to rotate the person from side to side. Another examplemay be the caregiver applying a salve to the person's skin. In somecontemplated embodiments, the therapy is configured to maintain theperson's skin within a predefined range.

In step 124, the processor 100 notifies the caregiver and/or activates atherapy. If the caregiver is notified, the notification can includeinformation about the current condition of the person and recommendedinterventions based on the care facility protocols. If the therapy isactivated, the processor 100 monitors the inputs 102 to adjust thetherapy to maintain the person with in a predetermined range of values.In some contemplated embodiments, the processor can receive informationthat causes the processor to deactivate the therapy or notify thecaregiver that an intervention is no longer necessary. In one example,if the caregiver is notified that the person needs to be turned and theperson turns themselves in the meantime, the caregiver can be notifiedthat the person no longer needs to be turned. In another example, if atherapy is scheduled to run, such as, heat and moisture regulationtherapy, and the person's skin temperature and moisture levels arewithin a predetermined range, the therapy can be delayed, rescheduled,or stopped.

Many other embodiments of the present disclosure are also envisioned.For example, a method comprises receiving an input indicative of afactor that contribute to the development of pressure ulcers; comparingthe input to a predetermined threshold; and if the input exceeds thethreshold, notifying a caregiver that a pressure ulcer may develop. Inone contemplated embodiment, input includes at least one of theinterface pressure, the skin temperature, the skin moisture level,presence of tissue damage, incontinence, presence of a pressure ulcer,lack of motion, lack of activity, presence of shear forces, presence offriction forces, and use of therapies. In another contemplatedembodiment, the input includes at least one of a spatial and temporalcomponent related to the factor. In another contemplated embodiment, thespatial component identifies the location where the factor was detected.In another contemplated embodiment, the temporal component identifiesthe duration the factor was detected. In another contemplatedembodiment, the input includes information received from an electronicmedical record system. In another contemplated embodiment, the inputincludes information indicative of the patient's risk for skinbreakdown. In another contemplated embodiment, the input includesinformation indicative of the patient's medical history. In anothercontemplated embodiment, the input includes information indicative ofthe patient's Braden score. In another contemplated embodiment, theinput includes information indicative of the medication the patient istaking. In another contemplated embodiment, the method furthercomprising the step of receiving a second input corresponding to aninstitutional care protocol. In another contemplated embodiment, theinstitutional care protocol includes at least one of an instruction touse a specialty surface, an instruction to use a heat and moistureregulating therapy, an instruction to use a catheter, an instruction torotate the patient, and an instruction to initiate a patient turningtherapy.

In another example, a method comprises receiving an input indicative ofa factor that contribute to the development of pressure ulcers;comparing the input to a predetermined threshold; and if the inputexceeds the threshold, activating a therapy configured to reduce themagnitude of the input. In one contemplated embodiment, the therapyincludes a patient turning therapy. In another contemplated embodiment,the therapy includes continuous lateral rotation therapy. In anothercontemplated embodiment, the therapy includes a heat and moistureregulating therapy. In another contemplated embodiment, the therapyincludes a low air loss therapy. In another contemplated embodiment, thetherapy includes a targeted cooling. In another contemplated embodiment,the therapy includes targeted repositioning. In another contemplatedembodiment, the therapy includes a patient turning therapy. In anothercontemplated embodiment, the method further comprising the step ofreporting compliance with an institutional care protocol. In anothercontemplated embodiment, the therapy includes delivery of a pHneutralizing solution.

In another example, a method comprises receiving an input indicative ofa factor that contribute to the development of pressure ulcers;determining a Braden score of a person as a function of the input;comparing the Braden score to a predetermined threshold; and if theinput exceeds the threshold, activating a therapy configured to reducethe magnitude of the input.

In another example, a method comprises receiving a first inputindicative of a factor that contribute to the development of pressureulcers; receiving a second input indicative of a factor that contributeto the development of pressure ulcers a predetermined time afterreceiving the first input; determining the difference between the firstinput and the second input; if the difference indicates an increase inthe factor that contributes to the development of pressure ulcers,activating a therapy configured to reduce the magnitude of the factor.

In another example, a method comprises receiving a first inputindicative of a factor that contribute to the development of pressureulcers; receiving a second input indicative of a factor that contributeto the development of pressure ulcers a predetermined time afterreceiving the first input; determining a first Braden score as afunction of the first input; determining a second Braden score as afunction of the second input; comparing the first Braden score to thesecond Braden score; and if the first Braden score is less than thesecond Braden score, activating a therapy configured to reduce themagnitude of the factor.

In another example, a method comprises receiving a first inputindicative of a factor that contribute to the development of pressureulcers; receiving a second input indicative of a factor that contributeto the development of pressure ulcers a predetermined time afterreceiving the first input; determining a first Braden score as afunction of the first input; determining a second Braden score as afunction of the second input; comparing the first Braden score to thesecond Braden score; and if the first Braden score is less than thesecond Braden score, notify a caregiver.

In another example, a method comprises receiving an first inputindicative of a characteristic of a patient; receiving a second inputindicative of at least one factor that contributes to the development ofpressure ulcers, wherein at least one of the at least one factor isignored as a function of the first input; comparing the second input toa predetermined threshold; if the difference indicates an increase inthe factor that contributes to the development of pressure ulcers, atleast one of activating a therapy configured to reduce the magnitude ofthe factor and notifying a caregiver.

In another example, a method comprises receiving an input indicative ofat least one factor that contributes to the development of pressureulcers; determining a risk score as a function of the input; comparingthe risk score to a previous risk score; and at least one of activatinga therapy configured to reduce the magnitude of the factor and notifyinga caregiver if the risk score is greater than the previous risk score.

In another example, a method comprises receiving an input indicative ofat least one factor that contributes to the development of pressureulcers; determining a risk score as a function of the input; comparingthe risk score to a previous risk score; and at least one of activatinga therapy configured to reduce the magnitude of the factor and notifyinga caregiver if magnitude of the difference is greater than apredetermined threshold.

In another example, a method comprises receiving an input indicative ofat least one factor that contributes to the development of pressureulcers; determining a risk score as a function of the input; receiving asecond input indicative of at least one factor that contributes to thedevelopment of pressure ulcers; determining a second risk score as afunction of the second input; comparing the second risk score to therisk score; and at least one of activating a therapy configured toreduce the magnitude of the factor and notifying a caregiver if themagnitude of the difference between the scores is greater than apredetermined threshold.

In another example, a method comprises receiving an input indicative ofat least one factor that contributes to the development of pressureulcers; determining a risk score as a function of the input; comparingthe risk score to a previous risk score; and at least one of activatinga therapy configured to reduce the magnitude of the factor and notifyinga caregiver if the rate of change between the risk score and theprevious risk score is greater than a predetermined threshold.

In another example, a method of predicting the occurrence of a pressureulcer comprises the steps of: receiving a first input signal indicativeof a physiological characteristic of a person supported on a personsupport structure; receiving a second input signal indicative of atleast one of a pressure ulcer risk assessment and a pressure ulcerhistory of a person; comparing the first input signal to a predeterminedthreshold; if the first input signal exceeds the predetermined thresholdand the second input signal indicates at least one of at least amoderate risk and a history of pressure ulcers, generating an alert. Inone contemplated embodiment, the physiological characteristic includesinterface pressure experienced by a person's skin. In anothercontemplated embodiment, the physiological characteristic includes aperson's skin temperature. In another contemplated embodiment, thephysiological characteristic includes a person's skin moisture level. Inanother contemplated embodiment, the physiological characteristicincludes the presence of an incontinence condition. In anothercontemplated embodiment, the physiological characteristic includes anamount of shear experienced by a person's skin. In another contemplatedembodiment, the physiological characteristic includes an amount offriction experienced by a person's skin. In another contemplatedembodiment, the physiological characteristic includes the location on aperson's body that the physiological characteristic corresponds to. Inanother contemplated embodiment, the pressure ulcer risk assessment isinput by a caregiver via an input on the person support structure. Inanother contemplated embodiment, the pressure ulcer risk assessmentinformation is received from an electronic medical record database. Inanother contemplated embodiment, the pressure ulcer history informationis received from an electronic medical record database. In anothercontemplated embodiment, the pressure ulcer risk assessment includes aBraden score. In another contemplated embodiment, the pressure ulcerrisk assessment includes a person's diagnosed condition. In anothercontemplated embodiment, the pressure ulcer risk assessment includes aperson's current medication side effects. In another contemplatedembodiment, the pressure ulcer risk assessment includes a therapystatus. In another contemplated embodiment, the pressure ulcer riskassessment includes a mattress type. In another contemplated embodiment,a therapy is activated if the first input signal exceeds thepredetermined threshold and the second input signal indicates at leastof at least a moderate risk and a history of pressure ulcers. In anothercontemplated embodiment, the therapy includes continuous lateralrotation. In another contemplated embodiment, the therapy includes lowair loss therapy. In another contemplated embodiment, the therapy isdirected toward the location where the pressure ulcer is predicted tooccur.

In another example, a method of predicting an occurrence of a pressureulcer comprises the steps of: receiving a first input signal indicativeof a physiological characteristic of a person at a first time; receivinga second input signal indicative of the physiological characteristic ata second time; determining if a pressure ulcer is likely to occur basedon the first input signal and the second input signal; and generating anintervention if a pressure ulcer is likely to occur. In one contemplatedembodiment, the physiological characteristic includes at least one of aninterface pressure, a skin temperature, a skin moisture level, an amountof shear, an amount of friction, an incontinence condition, and alocation that the physiological characteristic corresponds to. Inanother contemplated embodiment, a pressure ulcer is likely to occurwhen the difference between the first input signal and the second inputsignal indicates that the characteristic is increasing over time. Inanother contemplated embodiment, a pressure ulcer is likely to occurwhen the physiological characteristic exceeds a predetermined thresholdfor a predetermined period of time. In another contemplated embodiment,the intervention includes activating a therapy. In another contemplatedembodiment, the therapy includes at least one of rotational therapy andlow air loss therapy. In another contemplated embodiment, the therapy isdirected toward the location where the pressure ulcer is predicted tooccur. In another contemplated embodiment, the intervention includesalerting a caregiver.

In another example, a control system comprises: an input configured toreceive information corresponding to at least two of a physiologicalcharacteristic of a person, a pressure ulcer risk assessment, and amedical history of a person; a processor; and a memory unit includinginstructions configured to be executed by the processor, theinstructions, when executed by the processor, causing the processor toat least one of activate a therapy on a person support structure andgenerate an alert. In one contemplated embodiment, the physiologicalcharacteristic includes an interface pressure. In another contemplatedembodiment, the physiological characteristic includes a skintemperature. In another contemplated embodiment, the physiologicalcharacteristic includes a person's skin moisture level. In anothercontemplated embodiment, the physiological characteristic includes thepresence of an incontinence condition. In another contemplatedembodiment, the physiological characteristic includes an amount of shearexperienced by a person's skin. In another contemplated embodiment, thephysiological characteristic includes an amount of friction experiencedby a person's skin. In another contemplated embodiment, thephysiological characteristic includes the location on a person's bodythat the physiological characteristic corresponds to. In anothercontemplated embodiment, the pressure ulcer risk assessment is input bya caregiver via an input on the person support structure. In anothercontemplated embodiment, the pressure ulcer risk assessment informationis received from an electronic medical record database. In anothercontemplated embodiment, the pressure ulcer history information isreceived from an electronic medical record database. In anothercontemplated embodiment, the pressure ulcer risk assessment includes aBraden score. In another contemplated embodiment, the pressure ulcerrisk assessment includes a person's diagnosed condition. In anothercontemplated embodiment, the pressure ulcer risk assessment includes aperson's current medication side effects. In another contemplatedembodiment, the pressure ulcer risk assessment includes a therapystatus. In another contemplated embodiment, the pressure ulcer riskassessment includes a mattress type. In another contemplated embodiment,a therapy is activated if the first input signal exceeds thepredetermined threshold and the second input signal indicates at leastof at least a moderate risk and a history of pressure ulcers. In anothercontemplated embodiment, the therapy includes continuous lateralrotation. In another contemplated embodiment, the therapy includes lowair loss therapy. In another contemplated embodiment, the therapy isdirected toward the location where the pressure ulcer is predicted tooccur.

In another example, a control system comprises: an input; a processorconfigured to receive information from the input corresponding to atleast two of a characteristic of a person, a pressure ulcer risk, and amedical history of a person; and a memory unit including instructionsconfigured to be executed by the processor, the instructions, whenexecuted by the processor, cause the processor to determine when apressure ulcer will likely occur based on the information received fromthe input, and generate an intervention if a pressure ulcer will likelyoccur. In one contemplated embodiment, the characteristic includes atleast one of an interface pressure, a skin temperature, a skin moisturelevel, the presence of an incontinence condition, a shear force, afriction force, and a location on a person's body that thecharacteristic corresponds to. In another contemplated embodiment, thepressure ulcer risk is input by a caregiver. In another contemplatedembodiment, the pressure ulcer risk is received from an electronicmedical record database. In another contemplated embodiment, thepressure ulcer history information is received from an electronicmedical record database. In another contemplated embodiment, thepressure ulcer risk includes at least one of a pressure ulcer riskscore, a diagnosed condition, a side effect of a current medication, atherapy status, and a mattress type. In another contemplated embodiment,the intervention includes activating a therapy. In another contemplatedembodiment, the therapy is activated if the first input signal exceedsthe predetermined threshold and the second input signal indicates atleast of at least a moderate risk and a history of pressure ulcers. Inanother contemplated embodiment, the therapy includes at least one of arotational therapy and a low air loss therapy. In another contemplatedembodiment, the therapy is directed toward the location where thepressure ulcer is predicted to occur. In another contemplatedembodiment, the intervention includes alerting a caregiver. In anothercontemplated embodiment, the alert is communicated through a nurse callsystem. In another contemplated embodiment, the alert is generated ifthe characteristic exceeds a predetermined threshold for a predeterminedperiod of time and at least one of the pressure ulcer risk indicates atleast a moderate risk and the pressure ulcer history indicates a historyof a pressure ulcers. In another contemplated embodiment, the pressureulcer risk is determined by populating a risk assessment table withinformation that is at least one of sensed by a sensing device andreceived from an electronic medical record.

In another example, a method of predicting the occurrence of a pressureulcer, comprising the steps of: receiving a first input indicative of aphysiological characteristic of a person supported on a person supportstructure at a first time; receiving a second input indicative of atleast one of a pressure ulcer risk assessment and a pressure ulcerhistory of a person; determining if a pressure ulcer is likely to occurbased on the first input and the second input; if a pressure ulcer islikely to occur, at least one of activating a therapy and alerting acaregiver. In one contemplated embodiment, the alert is generated if thephysiological characteristic exceeds a predetermined threshold for apredetermined period of time and at least one of the pressure ulcer riskindicates at least a moderate risk and the pressure ulcer historyindicates a history of a pressure ulcers. In another contemplatedembodiment, the therapy includes at least one of a rotation therapy anda low air loss therapy. In another contemplated embodiment, the therapyis directed toward the location where the pressure ulcer is predicted tooccur.

Any theory, mechanism of operation, proof, or finding stated herein ismeant to further enhance understanding of principles of the presentdisclosure and is not intended to make the present disclosure in any waydependent upon such theory, mechanism of operation, illustrativeembodiment, proof, or finding. It should be understood that while theuse of the word preferable, preferably or preferred in the descriptionabove indicates that the feature so described can be more desirable, itnonetheless can not be necessary and embodiments lacking the same can becontemplated as within the scope of the disclosure, that scope beingdefined by the claims that follow.

In reading the claims it is intended that when words such as “a,” “an,”“at least one,” “at least a portion” are used there is no intention tolimit the claim to only one item unless specifically stated to thecontrary in the claim. When the language “at least a portion” and/or “aportion” is used the item can include a portion and/or the entire itemunless specifically stated to the contrary.

It should be understood that only selected embodiments have been shownand described and that all possible alternatives, modifications,aspects, combinations, principles, variations, and equivalents that comewithin the spirit of the disclosure as defined herein or by any of thefollowing claims are desired to be protected. While embodiments of thedisclosure have been illustrated and described in detail in the drawingsand foregoing description, the same are to be considered as illustrativeand not intended to be exhaustive or to limit the disclosure to theprecise forms disclosed. Additional alternatives, modifications andvariations can be apparent to those skilled in the art. Also, whilemultiple inventive aspects and principles can have been presented, theyneed not be utilized in combination, and various combinations ofinventive aspects and principles are possible in light of the variousembodiments provided above.

1-51. (canceled)
 52. A method of predicting an occurrence of a pressureulcer, comprising the steps of: receiving a first input signalindicative of a physiological characteristic of a person at a firsttime; receiving a second input signal indicative of the physiologicalcharacteristic at a second time; determining if a pressure ulcer islikely to occur based on a trend indicated by the first input signal andthe second input signal; and generating an intervention if a pressureulcer is likely to occur.
 53. The method of claim 52, wherein thephysiological characteristic includes at least one of an interfacepressure, a skin temperature, a skin moisture level, an amount of shear,an amount of friction, an incontinence condition, and a location thatthe physiological characteristic corresponds to.
 54. The method of claim52, wherein a pressure ulcer is likely to occur when the differencebetween the first input signal and the second input signal indicatesthat the characteristic is increasing over time.
 55. The method of claim52, wherein a pressure ulcer is likely to occur when the physiologicalcharacteristic exceeds a predetermined threshold for a predeterminedperiod of time.
 56. The method of claim 52, wherein the interventionincludes activating a therapy.
 57. The method of claim 56, wherein thetherapy includes at least one of rotational therapy and low air losstherapy.
 58. The method of claim 56, wherein the therapy is directedtoward the location where the pressure ulcer is predicted to occur. 59.The method of claim 52, wherein the intervention includes alerting acaregiver. 60-79. (canceled)
 80. A control system, comprising: an input;a processor configured to receive information from the inputcorresponding to at least two of a characteristic of a person, apressure ulcer risk, and a medical history of a person; and a memoryunit including instructions configured to be executed by the processor,the instructions, when executed by the processor, cause the processor todetermine when a pressure ulcer will likely occur based on theinformation received from the input, and generate an intervention if apressure ulcer will likely occur.
 81. The control system of claim 80,wherein the characteristic includes at least one of an interfacepressure, a skin temperature, a skin moisture level, the presence of anincontinence condition, a shear force, a friction force, and a locationon a person's body that the characteristic corresponds to.
 82. Thecontrol system of claim 80, wherein the pressure ulcer risk is input bya caregiver.
 83. The control system of claim 80, wherein the pressureulcer risk is received from an electronic medical record database. 84.The control system of claim 80, wherein the pressure ulcer historyinformation is received from an electronic medical record database. 85.The control system of claim 80, wherein the pressure ulcer risk includesat least one of a pressure ulcer risk score, a diagnosed condition, aside effect of a current medication, a therapy status, and a mattresstype.
 86. The control system of claim 80, wherein the interventionincludes activating a therapy.
 87. The control system of claim 86,wherein the therapy is activated if the characteristic of the personexceeds the predetermined threshold and one of the pressure ulcer riskindicates at least of at least a moderate risk and the medical historyindicates a history of pressure ulcers.
 88. The control system of claim86, wherein the therapy includes at least one of a rotational therapyand a low air loss therapy.
 89. The control system of claim 86, whereinthe therapy is directed toward the location where the pressure ulcer ispredicted to occur.
 90. The control system of claim 80, wherein theintervention includes alerting a caregiver.
 91. The control system ofclaim 90, wherein the alert is communicated through a nurse call system.92. The control system of claim 90, wherein the alert is generated ifthe characteristic exceeds a predetermined threshold for a predeterminedperiod of time and at least one of the pressure ulcer risk indicates atleast a moderate risk and the pressure ulcer history indicates a historyof a pressure ulcers.
 93. The control system of claim 80, wherein thepressure ulcer risk is determined by populating a risk assessment tablewith information that is at least one of sensed by a sensing device andreceived from an electronic medical record. 94-97. (canceled)